IADR Abstract Archives
BLEACHING - PRINCIPLES AND TECHNIQUES
Objectives: Most people say they want white teeth – bleaching however does not necessarily involve making the teeth more white opaque and reflective but rather removing the extrinsic or intrinsic colour pigments and stains allowing the tooth to become whiter (higher value) but maintain their natural translucency. (Chu, Dervigus et al. 2004)
Methods: Whitening agents were used as far back as ancient Egypt. A mixture of pulverized pumice and wine vinegar, which they would apply with a chew stick to their teeth (Gargulinski 2012). Roman doctors recommended human urine to lighten teeth that of course contains urea and releases small amounts of hydrogen peroxide.
Three fundamental bleaching approaches exist, namely, dentist- supervised nightguard bleaching, in-office or power bleaching and mass market bleaching products (Heymann 2005). The three main bleaching agents are hydrogen and carbamide peroxide gels and sodium perborate and they all rely on chemical oxidation.
Results: The clinical measurement of the colour of teeth and the colour changes when whitening teeth have most commonly be done by bleaching one half of the mouth and comparing it to the other side using a standard shade guide (van der Burgt, ten Bosch et al. 1990).
Conclusions: Despite the wealth of studies on tooth bleaching materials there is still a great deal of research to be done. Although materials have evolved since Van Haywood’s original concept of vital bleaching in night trays essentially he had it right 30 years ago when he spotted the potential of the trauma work of Dr Bill Klusmier in 1968. (Haywood and Heymann 1989)
From the current evidence overnight bleaching with 10% Carbamine peroxide in custom made close fitting trays (Haywood 2008) incorporating a desensitising agent is the gold standard of whitening with success rates in the region of 98% for non-tetracycline stained teeth and 86% for tetracycline stained teeth. (Sulieman 2005)
(Leonard, Haywood et al. 1999) However were compliance is in doubt or speed is required “power” bleaching with hydrogen peroxide 21-38% is a more painful but very acceptable alternative.
Methods: Whitening agents were used as far back as ancient Egypt. A mixture of pulverized pumice and wine vinegar, which they would apply with a chew stick to their teeth (Gargulinski 2012). Roman doctors recommended human urine to lighten teeth that of course contains urea and releases small amounts of hydrogen peroxide.
Three fundamental bleaching approaches exist, namely, dentist- supervised nightguard bleaching, in-office or power bleaching and mass market bleaching products (Heymann 2005). The three main bleaching agents are hydrogen and carbamide peroxide gels and sodium perborate and they all rely on chemical oxidation.
Results: The clinical measurement of the colour of teeth and the colour changes when whitening teeth have most commonly be done by bleaching one half of the mouth and comparing it to the other side using a standard shade guide (van der Burgt, ten Bosch et al. 1990).
Conclusions: Despite the wealth of studies on tooth bleaching materials there is still a great deal of research to be done. Although materials have evolved since Van Haywood’s original concept of vital bleaching in night trays essentially he had it right 30 years ago when he spotted the potential of the trauma work of Dr Bill Klusmier in 1968. (Haywood and Heymann 1989)
From the current evidence overnight bleaching with 10% Carbamine peroxide in custom made close fitting trays (Haywood 2008) incorporating a desensitising agent is the gold standard of whitening with success rates in the region of 98% for non-tetracycline stained teeth and 86% for tetracycline stained teeth. (Sulieman 2005)
(Leonard, Haywood et al. 1999) However were compliance is in doubt or speed is required “power” bleaching with hydrogen peroxide 21-38% is a more painful but very acceptable alternative.